NPIMap

Organization Active NPI

Devaraj Behavioral Healthcare PLLC

  • Community/Behavioral Health Agency
  • Charleston, WV
National Provider Identifier
1356980916
Registry record updated Dec 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DEVARAJ BEHAVIORAL HEALTHCARE PLLC
Practice address
412 Tennessee Ave
Charleston, WV 25302-2338
Phone
(877) 338-2725
Fax
(304) 715-3537
NPI assigned
Dec 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jacob M Bounds, LGSWNPI 1154921799
Title
Clinical Director
Phone
(877) 338-2725

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

412 Tennessee Ave
Charleston, WV 25302-2338

Mailing address

412 Tennessee Ave
Charleston, WV 25302-2338
Phone (877) 338-2725

National Provider Directory

National Provider Directory
Tax ID family
Devaraj Behavioral Healthcare PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1109 Jefferson Rd
Ste C
South Charleston, WV 25309
Phone (304) 746-0795

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765670400000",
    "number": "1356980916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 TENNESSEE AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022338",
            "telephone_number": "877-338-2725",
            "fax_number": "304-715-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 TENNESSEE AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022338",
            "telephone_number": "877-338-2725",
            "fax_number": "304-715-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVARAJ BEHAVIORAL HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-31",
        "last_updated": "2025-12-14",
        "certification_date": "2025-12-14",
        "status": "A",
        "authorized_official_last_name": "BOUNDS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "877-338-2725",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LGSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.